Burden of stroke in indigenous Western Australians: a study using data linkage

Area of Science:

• Public Health
• Epidemiology
• Cardiovascular Disease Research

Background:

• Cardiovascular disease disproportionately affects Indigenous Australians, yet stroke-specific data remains limited.
• Western Australia has a significant Indigenous population (3.4%) that experiences a high burden of chronic disease.

Purpose of the Study:

• To document the incidence and burden of stroke (disability-adjusted life years) in Indigenous and non-Indigenous Western Australians.
• To compare stroke burden between these populations using data from 1997-2002.

Main Methods:

• Utilized linked hospital and mortality data to estimate stroke incidence and excess mortality rates.
• Adjusted for non-admitted stroke events and modeled nonfatal burden using incidence, duration, and disability weights.
• Calculated fatal burden from stroke death counts and summed nonfatal and fatal burden for disability-adjusted life years (DALYs).

Main Results:

• Total stroke burden was 55,099 DALYs for non-Indigenous and 2,134 DALYs for Indigenous Western Australians.
• Age-standardized stroke incidence rate ratios (≥15 years) were 2.6 for males and 3.0 for females, favoring non-Indigenous individuals.
• Stroke burden profiles differed significantly, with higher incidence rate ratios observed at younger ages for Indigenous populations.

Conclusions:

• A considerable disparity exists in stroke burden between Indigenous and non-Indigenous populations in Western Australia.
• Comprehensive intersectoral interventions are crucial to reduce Indigenous stroke incidence and improve outcomes.
• Policy development and outcome monitoring require quantitative data on stroke burden, emphasizing the need for risk factor reduction and culturally appropriate services.